TACKLING INDIA'S SICKLE CELL ANEMIA CHALLENGE

Sickle cell anemia (SCA), a hereditary red blood cell disorder, poses a serious public health challenge. Examine its prevalence, severity, and the steps that the healthcare sector needs to take.

In the heart of India's diverse landscape, a silent but serious health threat looms large: sickle cell anemia (SCA). Across tribal communities and urban centers alike, its impact indicates the urgent need of 360-degree strategies to address it.

India accounts for 14.5 percent of newborns with sickle cell disease (SCD), estimated to be over 42,000 annually. The phenotype of SCD in India was considered mild due to factors like higher fetal hemoglobin levels or co-inheritance of alpha thalassemia. However, recent studies highlight the severity of the disease, especially among tribal populations. Before reaching the age of two, 20 percent of tribal children with SCD die, and 30 percent do not survive to adulthood.

SCD is caused by either homozygous inheritance of the hemoglobin S mutation (HBSS) or compound heterozygous inheritance of the hemoglobin S mutation with another ẞ-globin chain abnormality. India has one of the highest hemoglobin S allele frequencies globally, and the third-highest birth rate for babies born with HbSS. The beta-sickle globin mutation (BS) is particularly common among aboriginal tribal populations (Adivasis) and historically disadvantaged groups known as scheduled castes. An estimated 1 in 86 births in these populations results in sickle cell anemia.

Stating that the situation is alarming along the Narmada River belt, Mahanadi River belt, and the jungles of Odisha, Dr Dinesh Pendharkar, Director - Oncology, Cell and Gene Therapy and Bone Marrow Transplantation, Sarvodaya Hospital, Sector 8, Faridabad, informs, "There are approximately 100 districts with a high prevalence. The average number of patients in these ranges varied between 1,000 and 2,000.The total number in the country is approximately three-lakh. In Africa most sickle cell anemia patients die before five years of age. Our child mortality data are not available."